Ladybug hypersensitivity: report of a case and review of literature

For years, allergists have known that inhalant allergens arise from insects such as flies, beetles, moths, cockroaches, and mites. Now, it is becoming evident that the Asian ladybeetle Harmonia axyridis possibly should be added to this list. Several cases have been reported recently in the literature describing patients suffering from allergic respiratory symptoms including rhinitis, conjunctivitis, and asthma related to exposure to ladybugs. These patients reveal positive skin-prick testing with ladybug extract and immunoglobulin E immunoblotting with the sera showing at least two distinct allergenic proteins. This species infests homes in very large numbers in the fall and winter months and stay there in a hibernation-like state until the warm weather arrives with early spring. We discuss avoidance measures, which are the key to successful treatment.